齿突游离小骨的影像学测量与手术治疗

目的：对齿突游离小骨的影像学测量及其手术治疗进行研究。方法：对已治疗的45例齿突游离小骨进行分析，其中38例采用3种影像学测量方法来评价C1-2不稳程度。所有病人均行后路融合术，其中寰枢椎融合28例，枕颈融合17例。结果：测量分析发现，上颈椎最大椎管矢状径＜13mm时有脊髓损害的危险。所有手术病人平均随访6年，均取得牢固骨性愈合。38例临床症状改善，4例无变化，3例加重。结论：对于齿突游离小骨伴有脊髓压迫症状，或仅有枕颈部症状但影像学测量椎管矢状径减小接近13mm这一临界值，有脊髓损害危险时应施行手术治疗。     

不稳定性齿突游离小骨的诊断及治疗：26例患者临床分析

目的通过临床病例分析探讨不稳定性齿突游离小骨的临床特点及后路融合手术的治疗效果。方法回顾性分析2005年5月-2012年5月本院采用手术治疗有临床症状的不稳定性齿突游离小骨患者26例。分析总结病史特点、临床表现、影像学表现及手术治疗效果。结果 26例患者中男16例,女10例。年龄36-66岁,平均43.3岁。15例既往有明确外伤史,21例患者有颈部症状,所有患者均有不同程度的神经损伤症状,术前神经功能日本骨科学会（Japanese Orthopaedic Association,JOA）评分8-15分,平均10.1分。所有患者影像学均有寰枢椎脱位表现,其中22例为可复性,有2例伴有上颈椎其他畸形。24例行后路寰枢椎融合术,2例行枕颈融合术,术中无椎动脉、脊髓损伤发生,术后平均随访26个月（12-36个月）,26例患者均达到骨性融合,无内固定松动、断裂等并发症。术后12个月,颈部症状及神经功能明显改善,JOA评分为12-17分,平均15.1分（P〈0.05）。结论不稳定性齿突游离小骨容易损伤脊髓,应尽早手术重建其稳定性,经后路融合手术安全有效。     

MRI评价退行性颈椎管狭窄的临床价值

目的分析退行性颈椎管狭窄(DCSS)的MRI表现特征,探讨MRI的临床实用价值。方法回顾性分析经临床和影像学检查确诊的43例DCSS患者的MRI表现,测量纤维性椎管矢状径、横径,计算压迫率,测量椎管最狭窄处脊髓的矢状径及横径,并计算与该部位的椎管矢状径、横径的比值,测量椎管狭窄处脊髓前间隙,观察椎间盘、前纵韧带、后纵韧带、黄韧带等的变化情况。结果43例患者纤维性椎管的平均矢状径为7.02±1.56mm,横径为17.64±2.11mm,平均压迫率为(39.79±8.14)%,椎管最窄处脊髓矢状径为5.46±0.97mm,与椎管矢状径比值为0.798±0.133,椎管横径为12.66±1.01mm,与椎管横径比值为0.724±0.071。椎管狭窄处脊髓前间隙平均值为0.14±0.35mm。所有患者均伴有颈椎退行性改变,其中椎间盘突出、膨出、变性多见(155/215),16例患者出现黄韧带增厚,13例患者出现后纵韧带增厚。结论DCSS的MRI表现具有一定的特征性,通过分析影像表现,可以明确疾病的诊断,对疾病的治疗有指导意义。     

经口咽松解复位后路减压融合治疗复杂枕颈畸形

[目的]探讨经口咽寰枢椎松解复位后路枕骨大孔扩大减压枕颈固定融合术治疗复杂枕颈畸形的临床疗效。[方法]回顾性分析2012年1月~2015年6月本科共收治并随访57例伴难复性寰枢关节脱位的复杂枕颈畸形患者的临床资料。采用持续颅骨牵引下经口咽寰枢椎松解复位+后路寰椎后弓切除枕骨大孔扩大减压枕颈固定植骨融合术治疗此类畸形,术前、术后1、3、6及12个月随访时行JOA评分和颈椎X线片、CT、MR检查,并测量齿状突超过Chamberlain线距离、延髓脊髓角(CMA)、寰齿前间隙(ADI)、枕大孔正中有效矢状径,所有患者根据手术前后JOA、VAS、NDI评分和测量影像学相关径线评价临床疗效。[结果]平均手术时间5.3 h,术中出血量62~220ml,术中置钉良好,未出现椎动脉损伤和脊髓损伤加重,术后鼻饲3~7 d,2周出院。术后无口咽部感染病例,枕颈部感染2例,经清创VSD负压吸引后均治愈。术前JOA评分6~12分,VAS评分0~7分,NDI评分8~40分,术后12个月JOA评分10~17,VAS评分0~4分,NDI评分5~19分,与术前比较差异有统计学意义。术后复查影像学检查示内固定稳定,植入骨块达骨性融合,术后齿状突超过腭枕线距离-10.00~6.90 mm;CMA 137.00°~159.50°,ADI值1.70~5.80 mm,枕大孔正中有效矢状径25.70~32.90 mm,分别与术前齿状突超过腭枕线(Chamberlain线)距离5.30~16.70 mm;CMA 109.00°~129.80°,ADI值5.30~9.10 mm;枕大孔正中有效矢状径6.00~18.80 mm,比较差异均有统计学意义。[结论]枕颈畸形采用经口咽寰枢椎松解复位后路枕骨大孔扩大减压枕颈固定融合术治疗,可使齿状突明显下移,纠正寰枢脱位,解除脊髓压迫,疗效满意。     

颈椎后路减压纳米人工椎板重建颈椎管的疗效分析

目的评估应用纳米人工骨重建颈椎椎管的临床疗效。方法对23例行颈椎后路减压人工椎板椎管重建术的患者进行随访。统计手术时间及术中出血量;采用JOA（日本矫形外科学会）评分标准评定患者脊髓神经功能状态;观察轴性症状及颈5神经根麻痹的发生情况;颈椎X线片及CT了解椎管矢状径扩大情况及人工椎板融合情况。结果手术时间平均92 min,术中出血量平均316 ml。人工椎板植入未见排斥反应,术后12月人工骨骨性融合率为45.5%。手术前后颈椎椎管矢状径差异有显著性,椎管矢状径均超过14 mm。JOA评分由术前平均9.6分增加至术后1年时平均15.1分,改善率为74.3%。3例出现轴性症状,理疗治疗后好转;未出现颈5神经根麻痹并发症。结论在颈椎后路减压手术中应用纳米人工椎板重建颈椎管可以获得较好的近期疗效。     

寰枢关节类风湿性关节炎的影像学分析(附21例报告)

目的评估累及寰枢关节的21例RA患者经联合治疗的临床效果及其影像学特征。方法对平均病程为7．95年（2～26年）的21例患者行MTX＋其他DMARDs的联合治疗，同时行临床和影像学评估，明确16例存在寰枢椎前向半脱位、3例垂直半脱位、2例侧方半脱位。6例有明显枕颈部症状的寰枢不稳息者行后路寰枢或枕颈融合治疗。结果联合治疗的有效率为85．7％。RA病程越长，越易发生寰枢椎不稳和椎管矢状径减小，本组前向寰枢椎半脱位最常见。6例手术患者的齿突周围血管翳在随访中较术前明显减小。结论对累及寰枢关节的RA患者，无论有无寰枢椎不稳、有无症状或脊髓损伤的体征，均可成功行影像学评估且行MTX＋其他DMARDs的联合治疗可取得较好的疗效；为防止枕颈部脊髓压迫，宜对此类患者行常规、定期的临床和影像学评估。     

正常人颈脊髓矢状径MRI测量

目的 提供颈脊髓矢状径、颈椎管有效矢状径(脑脊液柱矢状径)正常参考值,筛选出较科学的评估颈脊髓病的影像学标准.方法 在120例正常人颈椎MRI片上,对各节段颈脊髓矢状径、颈椎管有效矢状径、M值(桥脑-延髓交界处矢状径)进行测量,计算脊髓矢状径与椎管有效矢状径比值,以及脊髓矢状径和M值的比值(C/M值),研究它们与性别、年龄和颈椎长度的相关性.评估脊髓矢状径与椎管有效矢状径比值和C/M值的临床应用价值.结果 脊髓矢状径、椎管有效矢状径、M值男性大于女性(P<0.05),脊髓矢状径和椎管有效矢状径比值和C/M值男女无差别(P>0.05).颈脊髓矢状径和M值随着颈椎长度的增加而增加(r=0.215,P=0.010;r=0.151,P=0.020).颈脊髓矢状径和颈椎管有效矢状径比值与年龄成呈相关(r=0.242,P<0.01),与颈椎长度无明显相关(r=0.082,P=0.200).C/M值与年龄和颈椎长度均无相关性(r=0.06,P=0.359;r=0.003,P=0.900).结论 C/M值能够很好评价颈脊髓萎缩、受压、损害的状况,它很少受到个体差异的影响,是临床评估颈脊髓疾病的良好标准之一.     

齿状突游离小骨

齿状突游离小骨较少见到，但其可导致寰枢椎不稳与脊髓压迫。为引起临床医生的警惕，作者报告１７例齿状突游离小骨。除３例无症状者未行手术治疗外，１４例存在寰枢椎不稳者均行枕颈融合，术后均获骨性融合。本组病例术后随访２～１６年，临床症状消失或基本消失者９例，明显减轻者５例。３例非手术治疗者无变化。作者认为，对于齿状突游离小骨存在寰枢椎不稳者应行手术治疗     

纳米人工椎板在颈椎后路减压椎管重建手术中的临床应用研究

[目的]评估颈椎后路减压手术中应用纳米人工骨重建椎管后临床症状的改善和影像学变化。[方法]观察组30例多节段脊髓型颈椎病行颈椎后路减压人工椎板椎管重建术,对照组38例多节段脊髓型颈椎病行颈椎后路双开门椎管扩大成形术。两组术后平均随访25个月。比较两组的手术时间、术中出血量、术前术后JOA(日本矫形外科学会)评分,轴性症状及C5神经根麻痹的发生情况,颈椎X线片及CT了解椎管矢状径扩大情况及人工椎板融合情况。[结果]观察组手术时间平均92 min,术中出血量平均316 ml,低于对照组,有1例发生C5神经根麻痹。两组在手术时间、出血量及C5神经根麻痹的发生方面比较差异有统计学意义(P<0.05)。观察组术后JOA评分改善率为74.3%,3例出现轴性症状,理疗治疗后好转。术后各节段椎管矢状径皆超过14 mm,术后1年和2年人工骨骨性融合率分别为43.3%和71.1%。两组在JOA评分改善率、轴性症状发生率、椎管矢状径扩大及植骨融合方面比较差异无统计学意义(P>0.05)。[结论]在颈椎后路全椎板切除减压手术中应用纳米人工椎板重建颈椎管效果良好,获得与颈椎后路双开门椎管扩大成形术相同的治疗效果,而且具有手术时间短、术中出血少及并发症较少的优点。     

胸椎黄韧带骨化椎管侵占与神经损害的关系

目的探讨胸椎黄韧带骨化椎管侵占引发脊髓损害的临界值,建立脊柱多节段病变中确定责任节段的影像学诊断标准。方法采用病例对照研究,病例组取2002年1月至2007年4月因胸椎黄韧带骨化症行手术治疗者43例;对照组取2006年6月至2007年4月CT检查发现胸椎黄韧带骨化,而就诊前无明确神经损害者22例。在CT片上测量椎管矢状径、椎管发育性矢状径、椎管面积、椎管发育性面积,计算椎管矢状径残余率、椎管面积残余率。病例组患者的神经损害程度用JOA评分确定。结果影像学上椎管面积残余率与JOA评分相关性最大（r=0.449,P=0.003）。椎管面积残余率临界值取80%时诊断总符合率最高,其诊断灵敏度为93.0%,特异度为95.5%。结论（1）胸椎黄韧带骨化椎管侵占程度与神经损害程度相关,椎管面积残余率可以反映神经损害程度。（2）CT椎管面积残余率小于80%可作为胸椎黄韧带骨化引发脊髓损害的影像学标准。     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Is the recovery profile of mivacurium independent of the rate of decay of its plasma concentration in patients with normal plasma cholinesterase activity?

Background: The duration of action of muscle relaxants is poorly correlated to the rate of decay of their plasma concentration. The plasma concentration of mivacurium may rapidly decrease below its active concentration because of the extensive hydrolysis of mivacurium. By inflating a tourniquet on one upper limb for 3 min after the administration of atracurium, mivacurium or vecuronium, we studied the influence of the initial decline of their plasma concentration on their effect. Methods: In 50 patients anaesthetised with thiopental, isoflurane and fentanyl, the effect of bolus doses of 0.15 or 0.25 mg . kg^?1 mivacurium (MIV 15, MIV 25), 0.3 or 0.5 mg . kg^?1 atracurium (ATR 30, ATR 50) and 0.06 or 0.1 mg . kg^?1 vecuronium (VEC 06, VEC 10) were measured on both arms (evoked response of the adductor pollicis to train-of-four stimulation every 12 s), a tourniquet being applied on one arm just before and during 3 min after the muscle relaxant bolus. Results: Tourniquet inflation of 3 min almost abolished the neuromuscular effect of mivacurium. In the vecuronium groups and in the ATR 50 group, tourniquet inflation did not modify the maximum degree of depression of the twitch response. Also, the duration of action of vecuronium was unaffected by the tourniquet. In the ATR 30 group, times to return of the twitch response to 25% (duration 25%) and 75% (duration 75%) of control response were significantly shorter in the cuffed arm, 23 min vs 27 min, and 41 min vs 45 min, respectively. In the ATR 50 group, only duration 25% was significantly shorter in the cuffed arm (41 min vs 45 min). Conclusion: The results suggest that the rate of decline of the plasma concentration of mivacurium is so rapid, that a very low and almost clinically ineffective concentration is present as soon as 3 min after its administration. The results also indicate that the recovery from a mivacurium-induced neuromuscular blockade is not influenced by the rate of decay of its plasma concentration in patients with genotypically normal plasma cholinesterase.     

Membranes in Artificial Organs

Abstract: Membrane processes play a pivotal and enabling role in modern replacement therapy for acute and chronic organ failure and in the management of immunologic diseases. In fact, virtually all contemporary extracorporeal blood purification methods employ membrane devices, and the next generation of artificial organs and tissue engineering therapies are almost certain to be similarly grounded in membrane technology. In this short essay, we comment on the similarities and differences among synthetic membranes and their natural counterparts and also provide a critical overview of the demographics and technology of hemodialysis, hemofiltration, apheresis, oxygenation, and emerging membrane technologies and applications.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Dilemma of Membrane Biocompatibility and Reuse

Abstract: Numerous articles have been published on the multiple use of dialyzers and on the effect of different reprocessing chemicals and techniques on the dialyzer biocompatibility and performance. The results often appear contradictory, especially those comparing standard biocompatibility parameters. Despite this confusion, a discerning review of the published works allows certain limited conclusions to be drawn. Reprocessing of used hemodialyzers changes the biocompatibility profile of a dialyzer as defined by the parameters complement activation. leukopenia, and cytokine release. The effect of reprocessing depends on the chemicals and reprocessing technique applied and also on the type of membrane polymer being subjected to the reprocessing procedure. Reports of pyrogenic reactions indicate that the flux of the membrane also influences how suitable it is for safe reuse. An increased risk of allergic and pyrogenic reactions appears to be associated with dialyzer reuse. Furthermore, there has been a lack of investigations into the immunologic effect of the layer of adsorbed and chemically altered proteins that remains on the inner surface of reprocessed dialyzers. We conclude that the clinical benefit of dialyzer reuse cannot be generally accepted from a biocompatibility point of view.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.